Type 2 diabetes

T2D now being diagnosed in children as young as six

Children as young as six years old are being diagnosed with type 2 diabetes, according to Perth endocrinologists who are calling for early screening of at-risk groups.

Twelve children under the age of ten have been diagnosed with T2D since 2000 in WA, with the youngest of these being six years 11 months, according to Dr Jacqueline Curran, a paediatric endocrinologist at Princess Margaret Hospital, Perth.

In a research letter to the MJA, Dr Curran and colleagues say there were 193 reported cases of T2D in children under the age of 16 according to WA hospital records.

The high and increasing numbers of cases are cause for alarm for a disease that was rarely seen in children and adolescents before the 1990s, they say.

They warn that early-onset T2D appears to have a more severe phenotype compared with adult-onset T2D.

Nine of the 12 children under 10 years old with T2D  had one or more diabetes complications present at the time of diagnosis; seven had dyslipidaemia, two had an elevated albumin creatinine ratio, and three had hypertension.

Of the 11 children examined, ten had acanthosis nigricans present on their skin. Three children presented with polyuria and polydipsia, six were unwell with other illnesses and three were asymptomatic.

Type 1 diabetes antibodies were negative in seven of eight of the children tested, and the mean HbA1c level at diagnosis was 75 mmol/mol.

The common clinical features in early onset T2D were:

  • Parental type 2 diabetes.
  • Aboriginal/Maori heritage.
  • Obesity.
  • Female sex.

Dr Curran and colleagues concluded that the findings “provide strong evidence for the need to screen children with these risk factors for type 2 diabetes, irrespective of their age.”

“Moreover, the high prevalence of diabetes complications present strongly supports the need for complications screening at the time of diagnosis,” they added.

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